Browsing by Issue Date, starting with "2023-08"
Now showing 1 - 10 of 23
Results Per Page
Sort Options
- Optimizing the use of systemic corticosteroids in severe asthma (ROSA II project): a national Delphi consensus studyPublication . Marques, J.; Duarte-Ramos, F.; Ferreira, M. B.; Lima, R.; Lopes, C.; Sokolova, A.; Tonin, Fernanda; Loureiro, C. C.Although the prevalence of severe asthma is not high (5–10% of patients), it is responsible for a large part of the overall disease burden and costs (50–60% of total costs), especially if the condition remains uncontrolled (which occurs in around 40% of cases). Currently, for patients without disease control or presenting frequent exacerbations despite optimal therapy, add-on treatments, traditionally long-acting anticholinergics, oral corticosteroids (OCS), or biologic agents (monoclonal antibodies) are recommended. Nonetheless, the long-term use of oral/systemic corticosteroids (CS) is significantly associated with adverse effects, acute and chronic complications that may decrease health-related quality of life and worsen prognosis, thus requiring additional monitoring and management. Conversely, target therapies (i.e., omalizumab, mepolizumab, reslizumab, benralizumab, and more recently, dupilumab) have been developed grounded on the different phenotypes and endotypes of severe asthma, and are gradually reducing the reliance on OCS (i.e., greater specificity for achieving disease control by reducing the risk of exacerbations and requirements for rescue medication and OCS, with limited adverse events).
- Analysis of the relationship between performance and commitment in health professionals: a systematic reviewPublication . Pimenta, CarlaReview question / Objective Review question: What is the relationship between performance and commitment in health professionals? Main objective: To explore the extent and nature of the relationship between performance and commitment in health professionals, including the factors that influence this relationship. Specific objectives: 1. To systematically review the existing literature about the relationship between performance and commitment in health professionals. 2. To identify and analyze the factors influencing the relationship between performance and commitment in health professionals. 3. To assess the methodologies used to measure performance and commitment in health professionals.
- Plain radiography has a role to play in current clinical practice in Western SwitzerlandPublication . Reis, Cláudia; Gulizia, Marianna; Champendal, Mélanie; De Labouchere, Stephanie; Sun, Zhonghua; Silva, CarinaAim: The aim of the study was to investigate the current role of conventional radiography examinations in Western Switzerland and the main clinical indications required to justify the use of this imaging examination. Methods: Ethical approval was obtained from the Vaud Ethics Committee (Ref 2020–00311). An online questionnaire was specifically designed and implemented on the data collection tool LimeSurvey composed of two parts: a) to characterise the participants’ profile and their institutions and b) 169 projections for the different anatomical areas (upper and lower limbs, pelvis, skull, spine, thorax, abdomen) were presented to collect data about the frequency and main clinical indications. Statistical analysis was performed using the software IBM SPSS® (Statistical Package for the Social Sciences) version 26. Results: Radiographers from 60% (26/43) of the invited institutions participated in this survey, mainly from the Vaud region. The upper and lower limbs were the most commonly examined by using conventional radiography mainly for trauma and degenerative disorders. The thorax was also an anatomical area commonly explored by X-rays, and so was the spine (cervical and lumbar lateral). The skull radiographs were rarely performed in clinical practice and some of the projections were not being used, namely Hirtz, Tangential Nose Bones, Worms, and Caldwell's views. Conclusions: Plain radiography is being used in clinical practice mainly for appendicular skeleton studies and for trauma and degenerative pathologies. Adaptations in radiographers’ education and training and other healthcare professionals are needed to provide the judicious use of data that radiographs can give to better manage the patients’ imaging pathway.
- EANM procedural recommendations for managing the paediatric patient in diagnostic nuclear medicinePublication . Camoni, Luca; Santos, Andrea; Luporsi, Marie; Grilo, Ana; Pietrzak, Agata; Gear, Jonathan; Zucchetta, Pietro; Bar-Sever, ZviPurpose: The manuscript aims to characterize the principles of best practice in performing nuclear medicine procedures in paediatric patients. The paper describes all necessary technical skills that should be developed by healthcare professionals to ensure the best possible care for paediatric patients, as it is particularly challenging due to the psychological and physical conditions of children. Methods: We performed a comprehensive literature review to establish the most relevant elements of nuclear medicine studies in paediatric patients. We focused our attention on the technical aspects of the study, such as patient preparation, imaging protocols, and immobilization techniques, that adhere to best practice principles. Furthermore, we considered the psychological elements of working with children, including comforting and distraction strategies. Results: The extensive literature review combined with practical conclusions and recommendations presented and explained by the authors summarizes the most important principles of care for paediatric patients in the nuclear medicine field. Conclusion: Nuclear medicine applied to the paediatric patient is a very special and challenging area, requiring proper education and experience in order to be performed at the highest level and with the maximum safety for the child.
- A scoping review exploring stigma associated with postpartum urinary incontinencePublication . Cox, Jordyn; Sánchez-Polán, Miguel; Mota, Patrícia; Barakat, Ruben; Nagpal, TaniyaBackground: Postpartum urinary incontinence (PUI) occurs in 30–33% of individuals after their pregnancy, and has a detrimental impact on quality of life. Although common, PUI carries social stigma and this can affect patient behaviors, including not revealing symptoms and seeking appropriate care. Purpose: To summarize the causes of PUI stigma and its implications on health behaviors and outcomes. Methods: A scoping review was performed. The search was carried out on multiple search engines focusing on the postpartum period, urinary incontinence, and stigma. Data were extracted and mapped to identify causal factors of postpartum UI stigma and implications on outcomes and behaviors. Results: Twelve studies were included in this review. The main sources of PUI stigma were community values that negatively perceive urinary leakages as unclean and as lacking bodily control, along with self-stigma where participants seemed to be directing stereotypes and misconceptions surrounding PUI towards themselves. All studies emphasized that PUI was associated with feelings of embarrassment and shame, and this decreased the likelihood of discussing care options with healthcare providers. Conclusions: Moving forward, it is necessary to further understand PUI stigma from lived experience, including applying an intersectional approach to capture potential cultural nuances. Healthcare providers should be aware that PUI stigma could reduce patient communication, and therefore, the provider may need to initiate an effective and sensitive dialogue.
- Optimisation of exposure parameters using a phantom for thoracic spine radiographs in antero-posterior and lateral viewsPublication . Reis, Cláudia; Caso, M.; Dolenc, L.; Howick, K.; Lemmen, R.; Meira, A.; Shatku, F.; Aymon, E.; Ghotra, S. S.Introduction: To investigate the exposure parameters for thoracic spine/(TS) radiography that allows the image acquisition at the lowest dose possible, while maintaining an adequate image quality/(IQ) to identify all relevant anatomical criteria. Methods: An experimental phantom study was conducted, and 48 different radiographs of TS (24 AP/24 lateral) were acquired. The Automatic Exposure Control/(AEC) with the central sensor was used to select the beam intensity, while Source-to-Detector-Distance/(SDD) (AP:115/125 cm; Lateral:115/150 cm), tube potential (AP:70/81/90 kVp; Lateral: 81/90/102 kVp), use of grid/no grid and focal spot (fine/broad) were manipulated. IQ was assessed by observers with ViewDEX. Effective Dose (ED) was estimated using PCXMC2.0 software. Descriptive statistics paired with the intraclass correlation coefficient (ICC) were applied to analyze data. Results: The ED increased with a greater SDD for lateral view, presenting a significant difference (p = 0.038), however, IQ was not affected. For both AP and lateral, the use of a grid had a significant effect on ED (p < 0.001). Despite the images acquired without a grid had lower IQ scores, the observers considered the IQ adequate for clinical use. A 20% reduction in ED (0.042mSv–0.033 mSv) was observed when increasing the beam energy from 70 to 90 kVp for the AP grid in. The observers ICC ranged from moderate to good (0.5–0.75) in lateral and good to excellent (0.75–0.9) for AP views. Conclusions: The optimized parameters in this context were 115 cm SDD and 90 kVp with a grid for the best IQ and lowest ED. Further studies in clinical settings are necessary to enlarge the context and cover different body habitus and equipment.
- Experience and learning from the COVID-19 pandemic in Portugal: perceptions of community pharmacy professionalsPublication . Advinha, Ana Margarida; Santos, Margarida Custódio dos; Duarte-Ramos, Filipa; Perdigão, Margarida; Santos, Patricia; Oliveira-Martins, SofiaBackground: During the COVID-19 pandemic, community pharmacy (CP) professionals were among those who experienced the greatest risk of contracting SARS-CoV-2, which forced major adaptations. Objectives: The objectives of the study were to describe the changes implemented in CP professionals during the pandemic, understand the perception of professionals about their experience, and explore changes to remain. Methods: An observational and cross-sectional study was conducted via an online questionnaire (June–September 2020). The target population was CP professionals working in Portugal for >2 years and serving the public during the pandemic. Results: Of a total of 353 participants, 84% were female (mean age of 37.6 years), and 81% were pharmacists (mean professional experience of 12.9 years). In the management and organizational dimensions, the most mentioned changes were adaptation to legislative changes (90%), fluctuations in the treasury (82%), and reduction of working hours (46%). Only 2% resorted to simplified layoff. In the back office, there was a need to adapt stock management (93%) and purchase personal protective equipment (99%). In the front office, there was a change in service policies – wicket or conditional opening (92%), routes of the arrival of user requests (91%), and home delivery (82%). Physical changes occurred in 100% of pharmacies. The most frequently implemented procedures were the use of protection systems and PPE, articulation with hospital pharmacies for dispensing in proximity (75%), and training in this area (55%). Regarding interpersonal climate, improvements in the connection between team members are evident: increase in mutual help (57%), solidarity (54%), and group cohesion (50%); in the relationship with clients, the majority indicated the replacement of the usual user by third parties (71%), and changes in communication channels (increase in use of technological means 68%). Conclusions: Results illustrate the profound impact of the pandemic on CP professionals, both professionally and personally. It also highlights the importance of their roles in proximity and community support.
- The prevalence of astigmatism and spectacle wear in Polish schoolchildrenPublication . Kanclerz, Piotr; Bazylczyk, Natasza; Lança, CarlaIntroduction: Unilateral or asymmetric astigmatism is considered a principal refractive error leading to amblyopia and regular eye examinations should be carried out during childhood to prevent visual impairment. The aim of this study was to evaluate the prevalence of astigmatism and spectacle wear among Polish schoolchildren. Methods: A cross-sectional study was carried out in children aged 6 to 14 years old from 50 schools in Poland. The presence of astigmatism was assessed by non-cycloplegic autorefraction, and defined as a cylinder equal to or greater than 0.75 D. Children were classified as living in urban or rural areas according to the school location. Spectacle wear was defined as having spectacles at school. Results: The study included 1041 children and 52.3% were girls (n = 544). The mean age was 8.62 ± 2.04 years. The prevalence of astigmatism was 7.3% (95% confidence interval [CI]: 5.8–9.1%). Only 21.7% of children with astigmatism wore spectacles at school. Astigmatism was diagnosed in 8.2% of boys (95% CI: 6.0–11.0%) and 6.4% of girls (95% CI: 4.5–8.8%; p = .13); cylindrical anisometropia was present in 19/76 (25.0%) of children with astigmatism (95% CI: 15.8%–36.3%). Against-the-rule astigmatism was the most common; it was observed in 48.7% of children with astigmatism, followed by with-the-rule astigmatism (44.7%) and oblique astigmatism (6.6%). The prevalence of astigmatism was not linearly correlated with age (r = 0.24; p = .53). Gender, age, and place of living were not significantly associated with the presence of astigmatism. Conclusions: This study reports a low prevalence of astigmatism in Polish school children. However, the majority of children with astigmatism were uncorrected. Further, longitudinal studies are warranted.
- Neutrino physics: experimental and theoretical challengePublication . Gonzalez Felipe, RicardoThe existence of massive neutrinos is the first solid evidence of physics beyond the standard model of particle physics. A remarkable progress has been achieved in solar, atmospheric, reactor, and accelerator neutrino experiments during the last decades. On the theoretical side, several questions are being addressed, namely the Dirac or Majorana nature of neutrinos, the mechanisms for neutrino mass generation, and the relation between neutrinos and the matter-antimatter asymmetry observed in the Universe, among others. This article provides a brief overview on some of the current experimental and theoretical aspects in neutrino physics.
- Establishing standard operating procedures for isolation, characterizing and preservation of cells from oral potentially malignant disorders: a concept project proposalPublication . Costea, Daniela Elena; Ladeira, Carina; Vandis, Vera; Kozlakidis, ZisisStandard operating procedures (SOP) are crucial for the isolation, characterization, and biobanking of cells from tissues due to several key reasons: consistency and reproducibility, quality control, data integrity and Traceability, safety and ethics, resource efficiency, cross-training and knowledge transfer, regulatory compliance, publication and collaboration, and long-term research. This project aims to establish standard operating procedures (SOP) for isolating, characterizing, and biobanking cells from oral potentially malignant disorders (OPMDs).
- «
- 1 (current)
- 2
- 3
- »